Peri-rectal abscess +/- cellulitis
Incision/drainage necessary for abscesses.
Usual Pathogens
Polymicrobial:
Group A Streptococci
S. aureus
Anaerobes
Enterobacterales
No systemic symptoms/< 2cm
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Hot compresses |
Mild - no/minimal symptoms/> 2cm
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Amoxicillin-clavulanate | 40mg/kg/d PO div tid | 7-10 days |
Moderate-severe
| Empiric Therapy | Dose | Duration |
|---|---|---|
| [Clindamycin | 20-40mg/kg/d IV/PO div q8h | 10 days |
| + | ||
| Gentamicin] | 7mg/kg IV q24h | |
| or | ||
| [Cefazolin | 75mg/kg/d IV div q8h | 10 days |
| + | ||
| Metronidazole] | 30mg/kg/d IV/PO div q12h |
MRSA suspected - Mild
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Amoxicillin-clavulanate | 40mg/kg/d PO div tid | 7-10 days |
| + | ||
| TMP/SMX (if > 1 month old) | 8-12mg TMP/kg/d PO div bid |
MRSA suspected - Moderate-severe
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h | 10 days |
| + | ||
| Ceftriaxone | 50-75mg/kg IV q24h | |
| + | ||
| Metronidazole | 30mg/kg/d IV div q12h |